Healthy Children Project, Inc.
East Sandwich, MA 02537
Tel: (508) 888-8044

Our Latest Research

Breastfeeding Success Negatively Impacted by Common Labor Medications

Healthy Children Project, Inc. faculty conduct research and consulting throughout the United States and around the world. Our most recent research found that medications used during labor can have a negative effect on breastfeeding. The findings were epublished in Birth: Issues in Perinatal Care, October 2015.

Intrapartum drugs, including fentanyl administered via epidural and synthetic oxytocin, have been previously studied in relation to neonatal outcomes, especially breastfeeding, with conflicting results. We examined the normal neonatal behavior of suckling within the first hour after a vaginal birth while in skin-to-skin contact with mother in relation to these commonly used drugs. Suckling in the first hour after birth has been shown in other studies to increase desirable breastfeeding outcomes.

A strong inverse correlation was found between the amount and duration of exposure to epidural fentanyl and the amount of synthetic oxytocin against the likelihood of achieving suckling during the first hour after a vaginal birth.

For more information:The Association Between Common Labor Drugs and Suckling When Skin-toSkin During the First Hour After Birth

Below is a brief explanatory video about this groundbreaking study.


Changing practice in a hospital setting can be difficult – fraught with a list of barriers. A new research methodology, PRECESS, developed by a team of researchers from the US Healthy Children Project, Inc., and piloted by Healthy Children Project, Inc. (USA), Karolinska Intitutet (Sweden), Karolinska Hospital (Sweden), and the Egyptian Lactation Consultant Association (Egypt), uses ethnographic methods combined with hands-on expertise to drive lasting change. PRECESS stands for Practice, Reflection, Education and training, Combined with Ethnography for Sustainable Success.

The PRECESS methodology expects sustainable change in a short period of time, only five days. The PRECESS methodology provides an opportunity for clinicians who are experts in the new technique to work in a practical manner side-by-side with the staff of the changing hospital for a limited amount of time. The hospital staff at the changing hospital then have the responsibility to continue the new process. During the time together, the PRECESS team uses video ethnography and interaction analysis, combined with expert education and practical application of the new knowledge, to document the work practice in the hospital; to assist the staff in seeing their own work via interaction analysis, and to identify the barriers and solutions that, by necessity, would be unique to their situation.

Our services can be tailored to your organization. Our experts are available for consulting and keynote speeches.

The Consultants

Kajsa BrimdyrKajsa Brimdyr, PhD, CLC

Dr. Kajsa Brimdyr is an experienced ethnographer who has worked with health care, municipal and technological businesses, using ethnography to understand and appreciate the work practice of professions, work-flows and services in order to help improve practice. She has conducted research in the United States, Sweden, Latvia, Egypt, and Iceland. Her current research involves using video ethnography and interaction analysis to change practice in hospital settings to improve continuous skin-to-skin for the first hour after cesarean and vaginal births in Egypt and the United States. She, along with Ann-Marie Widstrom and Kristin Svensson, are the producers of the DVD skin-to-skin in the First Hour after Birth: Practical Advice for Staff after Vaginal and Cesarean Birth. Her newest DVD, the award-winning The Magical Hour: Holding Your Baby for the First Hour After Birth is aimed at parents. Dr. Brimdyr is an advisor and faculty member for the BS in Maternal Child Health: Lactation Consulting at Union Institute and University.

Ann-Marie WidstromAnn-Marie Widström, RN, MTD, Doctor of Medical Science

Dr. Ann-Marie Widström has conducted the foundation research that forms the basis of the 9 stages, and has been instrumental in the research that documents the importance of continuous, uninterrupted skin-to-skin contact in the first hour after birth. She is an associate professor at the Karolinkska Institute in Stockholm, Sweden. She has been a labour ward staff midwife, a lecturer at the Midwifery School in Stockholm,and head of the Department of Nursing including Midwifery Education at Stockholm University College of Health Sciences. She was co-project leader for developing interdisciplinary Centres for Clinical Education at four major hospitals in Stockholm during the merging of the University College and Karolinska Institutet. She has supervised several doctoral candidates at the Karolinska Institutet and published some 50 research articles. Her main research area is the inborn behavior of the newborn infant to find the mother’s breast when held skin-to-skin by the mother immediately after birth. Ann-Marie is also involved in working with teams to apply skin-to-skin under different cultural circumstances in Egypt as well as in USA.

Kristin SvennsonKristin Svensson, RN, Midwife, Doctor of Medical Science

Dr. Kristin Svensson is a midwife specialist in breastfeeding at the Department of Women's and Children's Health, Division of Reproductive Health, Karolinska Institutet, and at the Breastfeeding Center at Karolinska University Hospital, Solna. Her doctoral thesis: Practices that Facilitate or Hinder Breastfeeding addressed delivery and maternity practices that can impede breastfeeding and to develop methods to facilitate breastfeeding. Kristin is co-author of a Swedish breastfeeding book and author of breastfeeding chapters in several books. Her research focuses on the use of skin-to-skin in the community for solving difficult breastfeeding problems.